0001847420-21-000004.txt : 20211005
0001847420-21-000004.hdr.sgml : 20211005
20211005164129
ACCESSION NUMBER: 0001847420-21-000004
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211001
FILED AS OF DATE: 20211005
DATE AS OF CHANGE: 20211005
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Palmer Michael H
CENTRAL INDEX KEY: 0001847420
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-15555
FILM NUMBER: 211307278
MAIL ADDRESS:
STREET 1: 912 CORBETT DR
CITY: NORMAN
STATE: OK
ZIP: 73072
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Riley Exploration Permian, Inc.
CENTRAL INDEX KEY: 0001001614
STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311]
IRS NUMBER: 870267438
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0930
BUSINESS ADDRESS:
STREET 1: 29 E. RENO AVENUE
STREET 2: SUITE 500
CITY: OKLAHOMA CITY
STATE: OK
ZIP: 73104
BUSINESS PHONE: 405-415-8699
MAIL ADDRESS:
STREET 1: 29 E. RENO AVENUE
STREET 2: SUITE 500
CITY: OKLAHOMA CITY
STATE: OK
ZIP: 73104
FORMER COMPANY:
FORMER CONFORMED NAME: TENGASCO INC
DATE OF NAME CHANGE: 19960612
4
1
wf-form4_163346647628088.xml
FORM 4
X0306
4
2021-10-01
0
0001001614
Riley Exploration Permian, Inc.
REPX
0001847420
Palmer Michael H
C/O RILEY EXPLORATION PERMIAN, INC.
29 EAST RENO, SUITE 500
OKLAHOMA CITY
OK
73104
0
1
0
0
EVP CORPORATE LAND
Common Stock, par value $0.001 per share
2021-10-01
4
A
0
2080
0
A
21912
D
Common Stock, par value $0.001 per share
2021-10-01
4
F
0
997
23.48
D
20915
D
These shares are restricted stock acquired under Issuer's Riley Exploration Permian, Inc. 2021 Long Term Incentive Plan on October 1, 2021. Subject to certain contingencies and provisions allowing for accelerated vesting in certain instances, the shares of restricted stock vest in equal amounts on October 1, 2022, October 1, 2023, and October 1, 2024.
This amount includes 15,662 shares of restricted common stock subject to vesting and certain other restrictions.
These shares were surrendered to satisfy the withholding tax liability incurred upon the vesting of shares of restricted stock originally issued to the reporting person as a substitute equity award pursuant to the Riley Exploration Permian, Inc. 2021 Long Term Incentive Plan which converted a previously-issued equity grant at the closing of the Company's merger on February 26, 2021 and does not represent a discretionary trade by the reporting person
/s/Michael Palmer
2021-10-01